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Left atrial volume and function in patients with Behcet's disease assessed by real-time three-dimensional
Erdal Aktürk1, Jülide Yağmur, Ertuğrul Kurtoğlu
1Department of Cardiology, Faculty of Medicine, Adıyaman University, Adıyaman, Turkey. erdalakturk@hotmail.com
Insights
Behçet's disease (BD) patients show impaired left atrial (LA) function and volume changes, even without cardiac symptoms. This suggests subclinical cardiac involvement in BD, detectable through advanced echocardiography.
Area of Science:
- Cardiology
- Rheumatology
- Medical Imaging
Background:
- Behçet's disease (BD) is a multisystem inflammatory disorder with known cardiovascular complications.
- Cardiac involvement in BD, including arrhythmias and sudden death, is documented but not fully characterized.
- Subclinical cardiac dysfunction may precede overt cardiovascular events in BD patients.
Purpose of the Study:
- To evaluate left atrial (LA) volume and mechanical functions in asymptomatic BD patients.
- To utilize real-time three-dimensional echocardiography (RT3DE) for precise assessment of LA dynamics.
- To identify early signs of cardiac involvement in BD.
Main Methods:
- 40 BD patients and 30 healthy controls underwent comprehensive echocardiography.
- Real-time three-dimensional echocardiography (RT3DE) was used to measure LA volumes and mechanical functions.
- Demographic data, disease duration, and high-sensitive C-reactive protein levels were recorded.
Main Results:
- BD patients exhibited significantly higher LA maximum volume, LA before atrial contraction volume, LA active stroke volume, and total stroke volumes (TSV) compared to controls (P<0.0001).
- Total emptying and active emptying fractions, along with the expansion index, were significantly elevated in BD patients.
- LA passive emptying fraction was significantly lower in BD patients (41±7%) versus controls (44±5%, P=0.039).
- TSV showed positive correlations with high-sensitive C-reactive protein levels (r=0.413, P=0.008) and disease duration (r=0.417, P<0.007).
Conclusions:
- Left atrial mechanical functions and volumes are significantly impaired in patients with Behçet's disease.
- These findings indicate potential subclinical cardiac involvement in BD patients.
- RT3DE can detect early cardiac changes in BD, even in asymptomatic individuals.
Aims:
Behçet's disease (BD), a multisystemic inflammatory disorder, has been associated with a number of cardiovascular dysfunctions, including endomyocardial fibrosis of the right heart, atrial fibrillation, ventricular arrhythmias and sudden cardiac death. The incidence and nature of cardiac involvement in BD are not yet clearly documented. Our aim was to evaluate left atrial (LA) volume and functions using real-time three-dimensional echocardiography (RT3DE) in Behcet's patients without any cardiac symptom.
Methods And Results:
The study included 40 BD (16 females, 24 males and mean age of 33±7 years) and 30 healthy (11 females, 19 males and mean age of 35±6 years) subjects. All the patients' demographic parameters such as age, gender, and duration of BD were recorded. All the individuals underwent comprehensive 2D echocardiography examination, and RT3DE was performed to assess LA volumes and mechanical functions. LA maximum volume (Vmax) and before atrial contraction volume (Vpre A), LA active stroke volume and total stroke volumes (TSV), total emptying and active emptying fractions and expansion index were significantly higher in Behcet's disease patients when compared with the controls (P<0.0001 for all). LA passive emptying fraction was significantly lower in the patients with BD than in the controls (41±7 vs. 44±5, P=0.039). There were positive correlations between TSV and high-sensitive C-reactive protein level (r=0.413, P=0.008), TSV, and disease duration (r=0.417, P<0.007).
Conclusion:
Our study has shown that LA mechanical functions and volumes are impaired in BD. These results may be an early form of subclinical cardiac involvement in patients with BD who have no clinical evidence for cardiovascular disease.
